Atkinson Victoria P, Soeding Paul, Horne Greg, Tatoulis James
Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Victoria, Australia.
Ann Thorac Surg. 2008 Jan;85(1):310-1. doi: 10.1016/j.athoracsur.2007.02.002.
Cold agglutinins are of unique relevance in cardiac surgery because of the use of hypothermic cardiopulmonary bypass (CPB). Immunoglobulin M autoantibodies to red blood cells, which activate at varying levels of hypothermia, can cause catastrophic hemagglutination, microvascular thrombosis, or hemolysis. Management of CPB and myocardial protection requires individualized planning. We describe a case of aortic valve replacement in a patient with high titre cold agglutinins and a high thermal amplitude for antibody activation. Normothermic CPB and continuous warm blood cardioplegia were successfully used.
由于低温体外循环（CPB）在心脏手术中的应用，冷凝集素具有独特的相关性。针对红细胞的免疫球蛋白M自身抗体在不同程度的低温下被激活，可导致灾难性的血凝、微血管血栓形成或溶血。CPB的管理和心肌保护需要个体化规划。我们描述了一例主动脉瓣置换术患者，该患者冷凝集素滴度高且抗体激活的热幅度高。成功使用了常温CPB和持续温血心脏停搏液。
